Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted an announced Prelicensing and Component III visit to ensure that the home meets Title 22 requirements. LPA Yee met with Anna Armenyan, Applicant. The designated Administrator was not able join in on the visit.

The home is a single storey family home located behind another home located on the same lot. The home consists of a kitchen, dining room, living room, 3 bedrooms, 2 full bathrooms. The home is fire cleared for 5 non-ambulatory and 1 bedridden clients. Bedroom #1 is the designated room for bedridden use.

The following was observed on today's visit:

the living room was furnished with the appropriate furniture and seating for 6 clients. A locked cabinet used to centrally store medications and a linen cabinet was also observed in the living room.

the dining room was observed with a table and 6 chairs.

The kitchen is equipped with a stove, refrigerator, toaster and microwave. 8 each of dinner and salad plates, coffee cups, water cups, soup bowels were observed to be sufficient for 6 clients. 8 of each, dinner forks, dessert forks, teaspoons, spoons and dinner knives were observed. Pots and pans were observed for cooking. Sufficient non-perishable foods for a minimum of 7 days were observed at the the end of this visit. Additional non-perishable foods were ordered and delivered during this visit. Some perishable foods, such as chicken, pork, beef , chicken wings were observed in the freezer. Vegetables, milk and other perishable foods for a minimum of 2 days will be purchased prior to accepting the first client. Knives are stored in a locked kitchen drawer. Cleaning solutions and laundry detergent are locked in a metal cabinet outside.

Located in the kitchen is the only fire extinguisher purchased on 1/15/25.

Bedroom #1 (closest to the living room)was not furnished and no extra furniture was observed in storage.

Bedroom #2 was furnished with 2 twin beds, 2 chairs, 2 portable closet, 2 dressers, 2 lamps and a dresser used as a night stand between the beds. Windows had curtains for privacy. The beds had the